The Healthcare Practice of the Future: Integrated Practice
PRACTICE MANAGEMENT
Michael Carberry
For many healthcare business owners, the future is a confusing and scary place. There have been so many changes over the last two decades, and almost all of them have made it more difficult to survive in practice. Despite the legislative efforts made in the last decade to handle problems of the healthcare system, it seems that the wheels are coming off the train at a pace faster than at any point in the past. In fact, many of us wonder what practice will be like in even three to five years down the road. One thing is for sure—it won’t be the same as it is today.
When it comes to dreaming of a better practice, we have the responsibility as healthcare providers to prioritize the benefit to the patient at the top.
1. How can I build my practice so that it better serves my patients?
2. How can I maintain compliance with regulations that pertain to my business?
3. How can I build my practice so that it is more profitable tomorrow than it is today?
So, how can a chiropractor build a practice that better services the healthcare needs of his or her community? Certainly, there are many ways. One is to build an integrated healthcare center that offers many valuable services in addition to chiropractic. Ideally, these services aie congruent so that the theme
‘‘Doing so requires a chiropractor who is interested in business—i.e., interested in being an executive as opposed to just the doctor. 5 Ï
of the center is consistent—natural, preventive, and holistic.
By building a multidisciplinary integrated health center, the doctor creates a place where patients come and receive the care they need, as opposed to the care of only one licensed professional. When that patient arrives, his or her specific case is reviewed by professionals of various disciplines. The value in this for the patient is that he or she has a better chance of receiving the very best care for his or her condition. That care may be provided by a single professional within the healthcare center or by several different providers.
If a chiropractor owns this multidisciplinary integrated center, he or she has the opportunity to earn income not only from the delivery of chiropractic services, but also from all other services offered in the clinic. In addition, there are several other advantages of operating an integrated medical center (that includes chiropractic) over a traditional chiropractic practice.
Despite the obvious advantages of operating an integrated practice, it’s not for everyone. Doing so requires a chiropractor who is interested in business—i.e., interested in being an
Chiropractic Practice Integrated Practice 1. Better chance of surviving Affordable Care Act Changes. No Yes 2. Is widely accepted by public. No Yes 3. Marketing to the public is most effective. No Yes 4. Positions chiropractor as part of health a care team. No Yes 5. Better chance of services covered by Ins No Yes 6. Easier to take time off from work. No Yes 7. Treats a wider range of conditions. No Yes 8. More often a personality based practice. Yes No 9. Practice is easier to sell. No Yes
executive as opposed to just the doctor. It’s very rare for a chiropractor to own a medical center and also be the doctor in that practice delivering chiropractic care—wearing the hat of
administrator can be time consuming. However, for the chiropractor who has an associate and is ready for a new game, the medically integrated practice can be a rewarding endeavor
both personally and professionally. That is not to say that a chiropractor who is currently treating patients is not eligible to start making strides in the direction of an integrated practice. It just means that he or she is going to need to become comfortable managing other doctors.
Health care and business are games with constantly moving targets. To use a hockey analogy, the idea is to skate to where the puck will be, not to where it is right now. So determining where health care will be in the future should be of great interest to you as a business owner. Here are the factors that I consider most important in trying to answer this question.
First, what will the consumer want? This is important because, ultimately, the consumer is choosing where to buy healthcare services. If we compare a traditional chiropractic practice to an integrated medical center, the medical center wins in most cases.
Second, the consumer wants to have a greater chance to use insurance to obtain the care he or she needs. This is important because, for a large percentage of the population, insurance coverage is a factor that they insist on taking into consideration, sometimes to the known detriment of their own health. Of course, the practice that offers more insurancecovered services wins this comparison.
Third, if we take the same chiropractic practice and compare its potential success if operating as a stand-alone clinic or inside of a multidisciplinary center, the medical center wins hands down. This is because of the superior
“By building a multidisciplinary integrated health center, the doctor creates a place where patients come and receive the care they need, as opposed to the care of only one licensed professional. 5 5
positioning when inside of a medical center, as well as the referrals that the chiropractic practice will receive when aligned with other providers.
Finally, there has been a historic prejudice against the chiropractic profession, which has led to economic hardship for doctors of chiropractic. This hardship has been due to the negative image of chiropractic in the minds of consumers because of the negative PR campaigns executed by some in the medico-pharmaceutical industrial complex. Many feel it has also resulted in discrimination against chiropractors by the insurance industry. Two major barriers to success in chiropractic practice aie low acceptance by the public and poor insurance reimbursement. When a chiropractor choses to own a medical center, these two obstacles to success disappear because the chiropractor now runs a business that includes chiropractic services, but it is not dependent on the chiropractic practice to be viable!
At one time, my chiropractic practice saw more than 700 patient visits each week. I built that practice on a sound philosophy of health and wellness. I have injected that same passion for natural healing into the multidisciplinary practices that I own, and chiropractic is the magic ingredient of those integrated centers. I mention this simply because the final barrier many chiropractors run into when they consider hiring an MD or NP is that they are concerned about “selling-out.” If you build an integrated medical clinic centered around the traditional chiropractic philosophy of natural healing, health, and wellness, “selling-out” is the last thing you are doing.
Regardless of the future course of your professional practice, make sure that you take time to consider the future of health care. Your future and the future healthcare options available to your patients depend on it!
Michael Carberry, DC is the President andfounder of Advanced Medical Integration (AMI), a consulting group which assists practice owners to integrate medical services with chiropractic and rehab services. To learn more about AMI visit http.V/www.AMIdoctors. com. Dr. Carberry first brought medical services into his original chiropractic practice in 1995. Since then, Dr Carberry has owned several medically integrated clinics in multiple states. Dr. Carberry also lectures nationally on business systems and chiropractic philosophy. You can contact Advanced Medical Integration at 888-777-0815
